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New obesity advice from NICE backs 3% weight loss goal


Obese or overweight people are being told that losing as little as 3% of their weight can have significant beneficial effects, in new NHS guidance urging a “respectful and non-judgemental” approach to the problem.

Stigmatising obese and overweight people with a “for goodness sake pull yourself together” approach does not work and can deter people from seeking help, according to latest guidance from the National Institute for Health and Care Excellence.

“Even a 3% loss, kept up long term, is beneficial”

Carol Weir

It has also told primary care health professionals to identify people who can be referred for weight management programmes such as Weight Watchers in a bid to help them slim down.

Providers of weight loss courses would have to demonstrate that participants maintain their weight loss and their programmes are effective at 12 months or beyond.

NICE said programmes run by Rosemary Conley, Slimming World and Weight Watchers had been shown to be effective at 12 to 18 months. It also suggested the body Public Health England could be a national source of information on programmes suitable for commissioning.

In its new guidance, the institute acknowledged the difficulties many people faced losing weight and maintaining their weight loss, saying there was “no magic bullet” to the “complex” problem.

“It is not just a question of ‘for goodness sake pull yourself together and lose a stone’”

Mike Kelly

NICE said evidence showed that an effective weight loss programme where participants receive support from “buddies” and advice on lifestyle and behavioural changes can lead to an average 3% weight loss, which if kept off for the long term, will have beneficial health effects.

Carol Weir, guidance developer for NICE and head of service for nutrition and dietetics at Leeds Community Healthcare Trust, said the institute recognised the difficulties people faced losing weight and the “significant” effort required to prevent a regain of the weight once lost.

“Obviously, if you need to lose weight, the more weight you lose the better, and the health benefits derive from that, but even a 3% loss, kept up long term, is beneficial and that is why we are recommending sensible changes that can be sustained life long,” she said.

She added: “The evidence tells us that the elements of an effective programme are sensible changes to diet, an increase in physical activity that can be sustained in the long term and changing behaviours using a range of techniques and tools, such as setting realistic and achievable weight loss goals, regular weight loss monitoring, a food and physical activity diary, planning ahead, having a buddy, and using a respectful and non-judgemental approach.

“What we found was that an awful lot of people are put off seeking support for their weight because they have either experienced or perceived stigma in the past.”

Professor Mike Kelly, director of the centre for public health at NICE, noted that losing weight was often difficult.


Mike Kelly

“It is not something where you can just wake up one morning and say ‘I am going to lose 10llbs’ − it takes resolve, it takes encouragement, and one of the things about involvement in these programmes is the mutual support from others who try to do the same thing seems to be hugely helpful from a motivational point of view,” he said.

“It is not just a question of ‘for goodness sake pull yourself together and lose a stone’ − it doesn’t work like that, what we are trying to acknowledge here is the reality that people carrying excess weight face,” he added.




Readers' comments (2)

  • I wish the GP's would take this matter a bit more seriously, but since they don't seem particularly interested in what NICE says or doesn't, is it likely?

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  • Do you really think GPs have the time in their 10 min. per patient consultations? they just seem to treat patients' presenting symptoms now and if their case is too complex they expect them to return for several visits. all they may get is to be told to lose weight and possibly a little more advice if they ask for it. GPs are so fixated on documenting their findings and looking at the notes on their screens they have little time to observe their patients or engage in any sort of therapeutic relationship, so unless it is pointed out to them by the patient they may even fail to notice they are overweight!

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